Pass the parcel: Service provider views on bridging gaps for youth with dual diagnosis of intellectual disability and mental health disorders in regional areas.

AIM: Youth with both intellectual disability (ID) and mental health (MH) disorders (dual diagnosis) have complex physical and MH needs that can make providing integrated care for this complex group challenging. We conducted a mixed methods needs assessment to identify gaps and challenges in care delivery, identify bridges for these and identify what works well in existing services. METHODS: Our research team recruited service providers (n = 126) caring for youth aged 14-24 years with a dual diagnosis in the Illawarra Shoalhaven region of New South Wales, Australia, to participate in focus group interviews. Data were transcribed and analysed thematically. RESULTS: We identified six themes related to caring for youth with dual diagnosis in regional areas: access to services and information about services, communication between service providers and with clients and carers, the divide between MH and ID, early intervention and health promotion, capacity building of service providers and capacity building of clients and carers. Across these themes, service providers highlighted the transition from child to adult services as a particularly challenging time for clients, families and carers. CONCLUSIONS: Our data suggest several approaches to break down silos and to facilitate collaboration between current services for youth with a dual diagnosis, including increasing specialised ID/MH services and building the capacity of current disability and MH service providers. Our results provide important information to provide quality and integrated care for youth with complex health needs.

"Improving Access to Early Childhood Developmental Surveillance for Children from Culturally and Linguistically Diverse (CALD) Background".

INTRODUCTION: Developmental vulnerabilities in pre-school aged children from culturally and linguistically diverse (CALD) backgrounds with low English proficiency are less likely to be identified through universal developmental surveillance. Barriers include low parental health literacy and low rates of attendance to mainstream child and family health services. Late detection of developmental vulnerabilities can have lifelong impacts on life trajectory. METHOD: Integrated outreach early childhood developmental surveillance was trialled in South East Sydney by local health services with non-government organisations (NGO) delivering early childhood education and support. NGO staff were trained in Parents Evaluation of Developmental Status (PEDS), a validated developmental screening tool to explore parental/carer and provider concerns [1]. Families with children identified with developmental concerns by NGO staff were referred to co-located or visiting Child and Family Health Nurses (CFHN), community child health, speech pathology or developmental services for developmental screening, assessment and/or care planning. RESULTS: Integrated health and NGO services improved access to developmental surveillance for CALD families in a non-threatening environment enabled by co-locating CFHN, or through visits by paediatric medical/speech pathology staff to participating playgroups. CONCLUSIONS AND DISCUSSION: Integration supported vulnerable families from CALD backgrounds to access developmental surveillance through child and family health services but required flexibility and adjustments by all involved.